ABSTRACT

Breakthrough pain is stili not routinely recognized, evaluated, and treated. Careful opioid titration may improve baselıne analgesia while limiting adverse effects. The goal of pain management is to individualize rescue medication according to the underlying mechanisms. Treatments that employ non-opioid drugs make it possible to overcome the comman problem of analgesic tolerance to opioids. Each patient's cancer pain is a mosaic whose mechanisms, locations, and temporal patterns fit together into an individualized picture.

Although preclinical models of cancer pain now permıt a deeper understanding of each of these elements- particularly breakthrough pain-the need to address each element and integrate therapies to improve quality of ife will challenge front- line clinicians, patıents, and their families for same time to come.